| NPI | 1265061204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1022139) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MA 1022139) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-06-08 |